Can Cervical Cancer Be Prevented
Cervical cancer occurs when cells in the cervix grow and divide uncontrollably. Unlike many other cancers whose causes are largely still unknown, cervical cancer is most often caused by human papillomavirus . Women can get an HPV vaccine, which protects against the strains of HPV that are most likely to lead to cervical cancer. While this wont completely eliminate your chances of developing cervical cancer, it does help lower your risk.
Importantly, a well-proven way to prevent cervical cancer is to have routine screening tests in this case the Pap test and/or HPV tests. These tests can help your physician detect abnormal changes in the cervix before cancer fully develops. When detected early, cervical cancer is highly treatable.
Medically reviewed by Jing-Yi Chern, MD, ScM, gynecologic oncologist
Moffitt Cancer Center offers comprehensive screening, diagnostic and treatment services for patients with cervical cancer. If you are showing symptoms of this condition, or if you have received a diagnosis and would like to explore your treatment options at Moffitt, request an appointment by calling or submitting a new patient registration form online. You do not need a referral.
Treating Small Cell Cancer
Small cell cervical cancers tend to grow more quickly than other types of cervical cancer. They are more likely to spread to the lymph nodes and other parts of the body.
Because of this, treatment for small cell cervical cancer can be more intensive than for the other cervical cancer types. It usually means you have a combination of different treatments. The treatment that is best for you will depend on the size of the tumour and whether it has spread, as well as your general health.
About Abnormal Cells In The Cervix That Can Become Cancer
Cervical cancer begins when healthy cells on the surface of the cervix change or become infected with human papillomavirus and grow out of control, forming a mass called a tumor. Long-term infection of HPV on the cervix can result in cancer, leading to a mass or tumor on the cervix. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can spread to other parts of the body. A benign tumor means the tumor will not spread.
At first, the changes in a cell are abnormal, not cancerous, and are sometimes called “atypical cells.” Researchers believe that some of these abnormal changes are the first step in a series of slow changes that can lead to cancer. Some of the atypical cells go away without treatment, but others can become cancerous. This phase of precancerous disease is called “cervical dysplasia”, which is an abnormal growth of cells. Sometimes, the dysplasia tissue needs to be removed to stop cancer from developing. Often, the dysplasia tissue can be removed or destroyed without harming healthy tissue. However, sometimes a hysterectomy is needed to prevent cervical cancer. A hysterectomy is the surgical removal of the uterus and cervix.
Treatment of a lesion, which is a precancerous area, depends on the following factors:
The size of the lesion and the type of changes that have occurred in the cells
The patient’s desire to have children in the future
The patient’s age and general health
Preferences of the patient and the doctor
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What Is The Cervix
The cervix is the name for the lowest part of the uterus. Only women have a uterus. The uterus is where a baby grows and develops when a woman is pregnant. During pregnancy, the uterus grows a great deal in size. When a woman is not pregnant, the uterus is a small, pear-shaped organ that sits between a woman’s rectum and her bladder. The cervix connects the uterus with the birth canal . Your healthcare provider can look at your cervix and get a sample of cells during a routine pelvic examination.
Does Hpv Infection Always Lead To Cancer
Most instances of cervical cancer are caused by HPV infection. However, HPV infections don’t always lead to cancer.
Low-risk strains of HPV do not cause cancer. High-risk strains can put you at risk but are usually cleared by the immune system before they can do any harm.
Persistent, high-risk HPV infections that the immune system can’t tackle may lead to changes in squamous cells or glandular cells in the cervix. These cell changes can turn into cancer over many years.
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Screening Women Without A Cervix
Based on solid evidence, screening is not helpful in women who do not have a cervix as a result of a hysterectomy for a benign condition.
Magnitude of Effect: Among women without cervices, fewer than 1 per 1,000 had abnormal Pap test results.
- Study Design: Evidence obtained from a single cohort study.
- Internal Validity: Good.
- External Validity: Good.
Are There Support Groups And Counseling For Cervical Cancer
Living with cervical cancer can present new challenges for you and your loved ones.
You might worry about how it will affect your everyday life. Many people feel anxious or depressed, and some are angry and resentful. Talking about your feelings and concerns can help.
Your friends and family members can be supportive. If you want to talk, let them know. They may be waiting for a cue from you.
Some people don’t want to “burden” their loved ones, or they prefer talking about their concerns with a more neutral professional. A social worker, counselor, or member of the clergy can help.
Many people get a boost from talking with others with similar experiences. Your hospital or medical center might have support groups. The American Cancer Society also has information about support groups all over the U.S.
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What Else Should I Know About Cervical Cancer
If youâve been diagnosed with cervical cancer, youâre sure to have a lot of questions. Maybe you just found out you have it, or maybe youâve already been through treatments and donât know what comes next.
Knowing the answers to these common questions can help you better understand your situation and make the best choices.
Can my cervical cancer come back?
In a lot of cases, treatment works and the cancer never comes back. But sometimes, it does — even if your doctor hasnât detected any signs of it for a long period of time. This is called recurrence.
Itâs impossible for your doctor to know how likely it is that your cancer will come back. But if itâs fast-growing, or advanced or widespread cancer, the chances are high. And it may be harder to treat.
If your cancer doesnât go away after your first treatment, you may have to get regular treatments such as chemotherapy and radiation to keep the cancer under control. Your doctor will discuss your options with you.
Am I more likely to get other cancers?
Even if youâve been treated for cervical cancer, that doesnât necessarily mean you canât get other types of cancers. In some cases, your chances of developing a second cancer could go up. After cervical cancer, you may be more likely to get:
Will I be able to have kids?
Your ability to get pregnant after getting cervical cancer will depend on the stage of your cancer and the type of treatment you have.
Causes And Risk Factors For Cervical Cancer
HPV infection is the main cause of cervical cancer. Over 90% of all cases of cervical cancer in the United States are caused by HPV.
Most people with HPV dont know they have it. Unless youre vaccinated , you can get HPV from an infected intimate partner without knowing it.
- Having many intimate or sexual partners
- Becoming sexually active at a young age
- Having sex with someone who is or was intimate with many partners
- Smoking cigarettes: Cigarettes contain chemicals that can damage the cells of the cervix, making you more vulnerable to infection.
- Long-term use of oral contraceptives: Birth control pills make cervical cells less resistant to persistent infection from high-risk HPV strains.
- Having a compromised immune system due to HIV or other conditions
- Family history of cervical cancer
- DES exposure: If the person who gave birth to you took DES during pregnancy, you might have an increased risk of a type of cervical cancer called clear cell adenocarcinoma. DES stopped being prescribed to pregnant people in the United States in 1971, so this risk factor has become increasingly rare.
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What About Hpv And Pregnancy
If someone has an abnormal Pap test during pregnancy, even if its severely abnormal, many healthcare providers will not do treatment, primarily due to the concern that it may accidentally cause early labor. They will just monitor the cervix closely with a colposcope during the pregnancy.
Sometime after delivery of the baby, the provider will look at the cervix again and do another Pap test or another biopsy. Many times after pregnancy, the cell changes will have spontaneously resolved, and no treatment will be necessary. The types of HPV that can cause cell changes on the cervix and genital skin have not been found to cause problems for babies.
How Do You Know If You Have Cervical Cancer
Most people will not know they have cervical cancer until they are formally diagnosed with the disease. Your healthcare provider will be able to confirm cervical cancer through a series of tests and biopsies. The first signs of cervical cancer are usually mild and can only be detected by your healthcare provider. Advanced stages of cervical cancer are more likely to cause signs and symptoms.
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Purpose Of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about cervical cancer screening. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions.
Changes To This Summary
The PDQ cancer information summaries are reviewed regularly and updated asnew information becomes available. This section describes the latestchanges made to this summary as of the date above.
Revised to state that based on solid evidence, regular screening with the Papanicolaou test leads to additional diagnostic procedures and possible overtreatment for low-grade squamous intraepithelial lesions. Also added text to state that excisional procedures to treat preinvasive disease has been associated with increased risk of long-term consequences for fertility and pregnancy .
Revised to state that testing for HPV DNA as a primary screening test is an option for women aged 30 years and older.
Added to state that cytology can be used to triage after primary HPV screening. Triage with cytology can be improved with concomitant detection of p16 and Ki-67 in the same cell. Dual stain can be assessed manually through immunostaining cervical cytology slides. Additionally, artificial intelligencebased deep learning algorithms are currently being investigated and applied to aid in automated identification of p16/Ki-67 dual-stained slides. This approach has been shown to improve specificity without sacrificing sensitivity over manual DS assessment, but it has not yet been validated in population studies .
Added as a new subsection.
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Jos Cervical Cancer Trust
We are also here to support you, whatever your diagnosis and whenever it was. Our 11:1 service offers a private way to get support over email, phone call or video call. We can talk through your personal situation, as well as helping you process your feelings and think about next steps. We also welcome partners and family members to use our 1:1 service, so if you are a loved one reading this or think yours would benefit from some extra support, get in touch.
Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own whichever feels most comfortable. It even has a section dedicated to small cell cervical cancer. If you would like to connect with others who have a small cell cervical cancer diagnosis, contact us at We will do our best to put you in touch with someone.
If you have general questions about small cell cervical cancer, our panel of medical experts may be able to help. They cant give you answers about your individual situation or health its best to speak with your GP or healthcare team for that.
Rare Types Of Cervical Cancer
Other types of cancer may develop in the cervix, but these are rare. They include:
Adenosquamous carcinomas occur when both types of cells are involved in cervical cancer. There are varying definitions of the types of cancer that fall under this category, making it difficult to estimate their prevalence. Adenosquamous carcinoma of the cervix is estimated to account for somewhere between 2 percent and 50 percent of all invasive cervical carcinomas, according to a study published in Modern Pathology.
Glassy cell carcinomas are considered a subtype of adenosquamous carcinomas. As of 2019, this extremely rare cancer had been reported fewer than 15 times in scientific literature, according to researchers in the American Journal of Case Reports. While treatment options arent standardized, radiation therapy may be combined with surgery.
Neuroendocrine carcinomas of the cervix make up less than 2 percent of all cervical cancers, according to the International Journal of Gynecological Cancer. In the United States, about 200 women are estimated to be diagnosed with this cancer every year.
Sarcomas that begin in the cervix are also rare, accounting for fewer than 1 percent of all cervical cancers, according to Diagnostic Pathology. Symptoms may resemble other types of cervical cancer and include abnormal vaginal bleeding and abdominal pain. Treatment regimens for cervical sarcomas arent standardized and may vary, but a combination of surgery and chemotherapy may be used.
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Tests And Procedures Used To Stage Cervical Cancer
If you are diagnosed with cervical cancer, you will be referred to a gynecologic oncologist. This is a doctor who specializes in staging and treating cervical cancer and other cancers of the female . They will recommend tests to determine the extent of cancer. Sometimes the cancer is only in the cervix. Or, it may have spread from the cervix to other parts of the body. The process of learning the extent of cancer in the body is called staging. It is important to know the stage of the cervical cancer in order to plan the best treatment.
For information about a specific stage of cervical cancer, see Cervical Cancer Stages.
The following procedures may be used to determine the cervical cancer stage:
- Complete blood count is a blood test that measures the following in a sample of blood:
the amount of hemoglobin in the red blood cells
the portion of the blood sample made up of red blood cells
- Blood chemistry study is a blood test that measures the amounts of certain substances released into the blood by organs and tissues in the body, including , , , , , and liver function values. An unusual amount of a substance can be a sign of cancer spread or other diseases.
For more information about lab tests used in cancer medicine, see Understanding Laboratory Tests.
Accuracy Of The Pap Test
Ideally, determining the sensitivity and specificity of a screening test would involve a study that applies a gold standard test to all participants . Sensitivity and specificity could be calculated. Such studies have rarely been done for any screening test for cervical cancer. Studies that compare the Pap test with repeat Pap testing have found that the sensitivity of any abnormality on a single test for detecting high-grade lesions is 55% to 80%. Because of the usual slow-growing nature of cervical cancer, the sensitivity of a program of regular Pap testing is likely higher.
To determine the sensitivity and specificity of the Pap smear, both a test threshold and a reference-standard threshold must be defined. In practice, atypical squamous cells of undetermined significance are often used as the test threshold, and CIN 1 is often used as the reference threshold. This combination gives a sensitivity of about 68% and a specificity of about 75%. A more appropriate test threshold may be LSIL, with a reference threshold of CIN 23. This combination gives a sensitivity of 70% to 80%, with a specificity of about 95%.
One important factor in the accuracy of the Pap test is the adequacy of the specimen obtained. Adequate training and using techniques such as the cytobrush may improve sensitivity.
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Are Routine Pelvic Exams Necessary
Sometimes. You and your healthcare provider can decide if you need a pelvic exam on the years that you aren’t due for cervical cancer screening. This is based your health history and sexual activity.
It’s still important to schedule routine care visits with your healthcare provider to discuss your sexual health and other concerns specific to your reproductive health. If you’re sexually active and under the age of 25, having annual screenings for chlamydia and gonorrhea may be recommended. Additionally, a clinical breast exam may help find lumps on your breasts.
What Can You Do To Reduce Your Risk
- Beginning at age 21, see your doctor and get regular PAP tests every 3 years.
- After age 30, get the PAP test and HPV test done every 5 years as recommended.
- Get the HPV vaccine before becoming sexually active .
- If you smoke talk to your doctor about how to quit.
- Eat a healthy, balanced diet with lots of fruits and vegetables, whole grains and lean protein.
- Know the signs and symptoms, and tell your doctor if you have:
- Bleeding between periods
- Bleeding after menopause, or after sexual intercourse
- Pelvic pain, pain during sexual intercourse, or unusual vaginal discharge
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